乳腺癌术后患者HIFU及RT去势治疗的临床研究

The Clinical Study of HIFU and RT Castrating for Breast Cancer Patients

目的:探讨高危乳腺癌根治术后患者HIFU去势治疗的安全性、有效性。方法:52例乳腺癌术后患者被随机分为HIFU去势治疗组(26例)和RT去势治疗组(26例)。HIFU组治疗2次/5天,焦域声强0.9～1.2kW/m2;RT组照射,DT14～18Gy/7～9次,共9～11天。结果:治疗1个月后,与治疗前相比,HIFU组其血中E1、E2激素水平显著下降(P<0.01和P<0.001);RT组E1、E2激素水平显著下降(P<0.05和P<0.01);HIFU组E1、E2激素浓度较RT组E1、E2激素浓度降低明显(P<0.05);HIFU组“更年期综合征”症状分布与RT组相比具显著性差异(P<0.01);HIFU组CD3+、CD4+有升高的趋势,RT组则相反(P>0.05)。两组治疗后闭经发生率均为100%(P>0.05)。结论:HIFU去势治疗疗效肯定,安全,是一种可达到放疗去卵巢治疗的非侵入性手段,并且可提高机体的细胞免疫力。

Objective:To evaluate the safety and effectiveness of HEFU castrating for breast cancerous patients after mastectomy if they are at a high risk of recurrence.Methods:We recruited52consecutive patients with primary operable breast cancer who were treated with mas-tectomy with excision of regional lymph nodes.Patients were divided into two groups with positive ER and PR immunohistochemical staining,un-menopause and over40years old by random allo-cation.In order to castration,26patients received two times HIFU treatment,and the other pa-tients received ra diotherapy with DT14-18Gy /7-9times /9-11days.Results:At one month of af-ter treatment,levels of serum E1and E2were significantly decreased comparison to before treat-ment in HIFU groups(P<0.01and P<0.001);the same changes were occurred in RT groups(P<0.05and P<0.01);the level of serum E1or E2in HIFU group was higher in comparison to RT groups(P<0.05);the symptoms distribution of 'climacteric syndrome ' in HIFU groups were signifi-cantly different in RT groups(P<0.01).After administration HIFU treatment,CD 3+ and CD 4+ subset ra tios in creased to different degrees;the follow-up time was4months.The incidence of amenor-rhea was100%in all patients.No serious complications were seen.Conclusions:We have shown that the use of HIFU in the castrating of patients with breast cancer is feasible、safe and effec-tive.This technology may provide a rapid noninvasive alterative toconventional bilateral oophorec-tomy or RT castration.In addition,HIFU maybe enhance cell-mediated immunity in the host.